Masoomeh Sofian - TPIRC (Tuberculosis and Pediatric Infectious Research Center), Arak University of Medical Sciences
Alireza Janbakhsh - Kermanshah University of Medical Sciences
Arezoo Aghakhani - Clinical Research Dept., Pasteur Institute of Iran
Mohammad Banifazl - Iranian Society for Support of Patients with Infectious Diseases

Background:Hepatitis B virus (HBV) vaccination is recommended for all HIV infected patients withoutHBV immunity. However, serological response to standard HBV vaccination is frequentlysuboptimal in this population and the appropriate strategy for re-vaccination of HIV infectednonresponders remained controversial. We aimed to determine the immunogenicity of onebooster dose of HBV vaccine given by ID or IM route in HIV positive nonresponders tostandard HBV vaccinationMaterials and Methods:In this study 42 HIV infected nonresponders were enrolled. We randomized them to receiveeither 10 μg for intradermal (ID) (20 cases) or 20 μg for intramuscular (IM) (22 cases)administration of HBV vaccine as a one booster dose. After one month, anti-HBs titer waschecked in all cases. A protective antibody response (seroconversion) defined as an anti-HBstiter ≥10 IU/LResults:Seroconversion was observed in 47.6% of subjects after 1 ID dose. 30% showed antibodytiters above 100 IU/L. Except 1 case, all responders had CD4+> 200 cells/mm3. Mean anti-HBs titer was 146.5±246 IU/L. After the one IM booster dose, seroconversion was observedin 50% of cases. 36.3% of subjects had anti-HBs ≥100 IU/L. All responders had CD4+> 200cells/mm3, except 1 case. Mean anti-HBs titer was 416.4±765.6 IU/L. Responders showedsignificantly higher CD4+ cell counts, in comparison to nonresponders (p<0.001)Conclusions:One booster dose administered IM or ID to HIV infected nonresponders resulted in similarrates of seroconversion, overall response rate 50%. However, higher anti-HBs titers observedmore frequently in IM group.